A new report from Together for Better Medicaid reveals states’ commitments to address social determinants of health (SDoH) and health equity through their partnerships with Managed Care Organizations (MCOs).
Together for Better Medicaid this week released the report, Medicaid Managed Care: Strategies to Address Social Determinants of Health & Health Equity, conducted by Health Management Associates (HMA) on how Medicaid Managed Care programs can support states’ efforts to address SDoH and health equity beyond the capabilities of traditional fee-for-service (FFS) models.
For the report, HMA evaluated 10 recent state requests for proposals to better understand how states are addressing key social determinants, such as income, education, food insecurity, housing insecurity, and unemployment, as well as health equity through MCO contracts. The organization found managed care to be better positioned to address such issues given their greater flexibilities, such as value-added services, in lieu of services, reinvesting savings, incentivizing outcomes, and contracting flexibilities.
The report identified several trends in state SDoH and health equity requirements:
- Many states require MCOs to conduct SDoH screenings of enrollees to determine the level of support needed
- More states require MCO care management programs to incorporate SDoH as well as coordinate with community-based organizations and make referrals to social services and supports to assist in addressing SDoH needs
- Some states require MCOs to address SDoH and provide staff training to better identify SDoH related needs
- States require MCO staff and providers to complete training to address racial and ethnic disparities to address cultural competency, implicit bias, and overall health equity issues
- States require MCOs to develop cultural competency plans, such as care management, marketing, and employment of a diverse workforce
- Some states incorporate health equity principles into their MCO pay-for-performance initiatives and others are focusing on health equity in value-based payment arrangements MCOs implement with provider networks
“It is anticipated that MCOs will continue to be a primary driver in Medicaid initiatives to address SDoH and health equity,” wrote report authors. “Medicaid managed care provides an opportunity to explore best practices in addressing these critical issues. To remain competitive in the market, MCOs will need to demonstrate innovation and outcomes in SDoH and health equity.”